Department I of Internal Medicine, Faculty of Medicine and University Hospital Cologne, Center for Integrated Oncology Aachen Bonn Cologne Duesseldorf (CIO ABCD), Excellence Center for Medical Mycology (ECMM), University of Cologne, Cologne, Germany.
Cologne Excellence Cluster on Cellular Stress Responses in Aging-Associated Diseases (CECAD), University of Cologne, Cologne, Germany.
Mycoses. 2020 Oct;63(10):1060-1068. doi: 10.1111/myc.13123. Epub 2020 Aug 29.
Regional differences in the underlying causes, manifestations and treatment of mucormycosis have been noted in studies covering Europe, Asia and South America.
To review cases of mucormycosis across the Middle East and North Africa (MENA) region in order to identify epidemiological, treatment and outcome trends in this region.
PATIENTS/METHODS: Cases of proven or probable invasive mucormycosis from the region were identified from the FungiScope database and the medical literature. For each case, information on underlying condition, site of infection, pathogenic species, therapeutic intervention, type of antifungal therapy and outcome were analysed.
We identified 310 cases of mucormycosis in the MENA region. The number of reported cases increased by decade from 23 before 1990 to 127 in the 2010s. In this region, the most common underlying conditions associated with mucormycosis were diabetes mellitus (49.7%) and conditions associated with immunosuppression (46.5%). The majority of patients received treatment with antifungals (93.5%), with a large proportion treated with both antifungals and surgery (70.6%). Overall mortality rates decreased from 47.8% before 1990 to 32.3% in the 2010s.
The number of reported cases of mucormycosis in the MENA region has risen over the past few decades, in line with increases in the number of patients with underlying conditions associated with this infection. Although the majority of patients received treatment with antifungal therapies and/or surgery, the associated mortality rate remains high and there is a clear need for more effective prevention and treatment strategies in the MENA region.
在涵盖欧洲、亚洲和南美洲的研究中，已注意到粘质霉病的潜在病因、表现和治疗在不同地区存在差异。
回顾中东和北非（MENA）地区的粘质霉病病例，以确定该地区在流行病学、治疗和结局方面的趋势。
患者/方法：从 FungiScope 数据库和医学文献中确定了来自该地区的确诊或疑似侵袭性粘质霉病病例。对于每个病例，分析了基础疾病、感染部位、病原种类、治疗干预、抗真菌治疗类型和结局等信息。
我们在 MENA 地区发现了 310 例粘质霉病。报告病例数按十年为单位呈递增趋势，1990 年前为 23 例，2010 年代为 127 例。在该地区，与粘质霉病相关的最常见基础疾病是糖尿病（49.7%）和与免疫抑制相关的疾病（46.5%）。大多数患者接受了抗真菌治疗（93.5%），其中很大一部分患者同时接受了抗真菌治疗和手术（70.6%）。总体死亡率从 1990 年前的 47.8%下降到 2010 年代的 32.3%。
在过去几十年中，MENA 地区报告的粘质霉病病例数量有所增加，与与这种感染相关的基础疾病患者数量增加一致。尽管大多数患者接受了抗真菌治疗和/或手术治疗，但相关死亡率仍然很高，该地区显然需要更有效的预防和治疗策略。
